目的:瑞美替罗姆的批准为代谢功能障碍相关脂肪性肝炎(MASH)患者带来了巨大的希望。这篇综述的目的是探讨其对全球健康环境的影响。提出了实施多学科管理MASH。
结果:Resmetirom对MASH的治疗有好处,并对其安全性和有效性进行了研究。需要注意不良事件(AE)。为了改善患者的预后,使用药物的多模式方法,如resmetirom,可以结合代谢和减肥手术(MBS)和生活方式干预。MASH,与肥胖有关的肝病,是一个具有挑战性的全球医疗保健负担,加上没有任何批准的药物治疗。美国食品和药物管理局(FDA)最近有条件批准了resmetirom,一个口头,肝脏定向,甲状腺激素受体β选择性激动剂,标志着一个重要的里程碑,为非肝硬化MASH和中度至晚期肝纤维化的成年人提供治疗选择。这篇叙述性综述讨论了resmetirom的疗效和安全性及其在MASH治疗治疗领域中的作用。尽管resmetirom对组织学肝终点的有希望的肝保护作用,它的使用需要进一步研究,特别是关于种族差异,有效性和成本效益,生产可扩展性,社会接受度和可及性。此外,将resmetirom与其他多学科治疗方法相结合,包括生活方式的改变和MBS,可能进一步改善MASH患者的临床肝脏相关和心脏代谢结局。这篇综述强调了综合治疗策略的重要性,支持持续的创新和合作研究,以完善管理MASH的治疗指南和共识,从而改善MASH全球流行中临床患者的预后。迄今为止所做的研究相对较短和持续,疾病的进程是高度可变的,不同患者的情况各不相同,鉴于这种复杂的临床表型,可能需要多年的临床试验才能显示出长期的益处。
OBJECTIVE: The approval of resmetirom brings great hope to patients with metabolic dysfunction-associated steatohepatitis (MASH). The purpose of this review is to explore its impact on the global health environment. The implementation of multidisciplinary management MASH is proposed.
RESULTS: Resmetirom has benefits in the treatment of MASH, and its safety and effectiveness have been studied. The adverse events (AEs) need to be noticed. To improve patient outcomes, a multimodal approach with medication such as resmetirom, combined with metabolic and bariatric surgery (MBS) and lifestyle interventions can be conducted. MASH, a liver disease linked with obesity, is a challenging global healthcare burden compounded by the absence of any approved pharmacotherapy. The recent conditional approval by the Food and Drug Administration (FDA) in the United States of resmetirom, an oral, liver-directed, thyroid hormone receptor beta-selective agonist, marks a significant milestone, offering a treatment option for adults with non-cirrhotic MASH and who have moderate to advanced liver fibrosis. This narrative review discusses the efficacy and safety of resmetirom and its role in the therapeutic landscape of MASH treatment. Despite the promising hepatoprotective effect of resmetirom on histological liver endpoints, its use need further research, particularly regarding ethnic differences, effectiveness and cost-effectiveness, production scalability, social acceptance and accessibility. In addition, integrating resmetirom with other multidisciplinary therapeutic approaches, including lifestyle changes and MBS, might further improve clinical liver-related and cardiometabolic outcomes of individuals with MASH. This review highlights the importance of a comprehensive treatment strategy, supporting continued innovation and collaborative research to refine treatment guidelines and consensus for managing MASH, thereby improving clinical patient outcomes in the growing global epidemic of MASH. Studies done to date have been relatively short and ongoing, the course of the disease is highly variable, the conditions of various patients vary, and given this complex clinical phenotype, it may take many years of clinical trials to show long-term benefits.